ABSTRACT
The mechanism of chronic pain is very complicated. Memory, pain, and opioid dependence appear to share common mechanism, including synaptic plasticity, and anatomical structures. A 48-yr-old woman with severe pain caused by bone metastasis of breast cancer received epidural block. After local anesthetics were injected, she had a seizure and then went into cardiac arrest. Following cardiopulmonary resuscitation, her cardiac rhythm returned to normal, but her memory had disappeared. Also, her excruciating pain and opioid dependence had disappeared. This complication, although uncommon, gives us a lot to think about a role of memory for chronic pain and opioid dependence.
Subject(s)
Female , Humans , Middle Aged , Amnesia/diagnosis , Anesthesia, Local/adverse effects , Bone Neoplasms/drug therapy , Breast Neoplasms/drug therapy , Cardiopulmonary Resuscitation , Electroencephalography , Heart Arrest/etiology , Magnetic Resonance Imaging , Mepivacaine/adverse effects , Pain Management , Seizures/etiology , Tomography, X-Ray ComputedABSTRACT
Spinal epidural hematoma is a rare but serious neurological complication of neuraxial anesthesia. Enoxaparin sodium is a low molecular weight heparin (LMWH) for use in preventing deep venous thrombosis in patients undergoing total hip arthroplasty and total knee arthroplasty. Hemorrhage is an uncommon but documented adverse reaction when using LMWH. We report a case of epidural hematoma after lumbar epidural anesthesia in a patient who administered enoxaparin in perioperative period.